The goal of this observational study o is to compare outcomes after either biological or mechanical aortic valve replacement. The main question it aims to answer: Is survival better after mechanical aortic valve replacement compared to biological aortic valve replacement? Are there less complications and reoperations after mechanical aortic valve replacement compared to biological aortic valve replacement? We perform a retrospective Data Collection of anonymized Austrian health insurance data.
Objectives: In recent years, age recommendations for the utilization of biological prostheses rather than mechanical prostheses for surgical aortic valve replacement (sAVR) have been significantly reduced. This study evaluated survival rates, major adverse cardiac events (MACEs), and reoperation risks following surgical (sM-AVR) and biological (sB-AVR) AVR, with the aim of providing data to inform optimal prosthesis selection for middle-aged patients between 50 and 65 years. Methods: A population-based cohort study was conducted using data from the Austrian Health System from 2010 to 2020. Patients undergoing isolated sAVR (n=3761) were categorized into sM-AVR (n=1018) and sB-AVR (n=2743) groups. Propensity score matching (PSM) was applied to balance covariates. The primary endpoint was all-cause mortality. The secondary endpoints included MACEs, reoperation, stroke, bleeding, and post-reoperation survival. Outcomes were assessed using Cox regression and Kaplan-Meier analyses.
Study Type
OBSERVATIONAL
Enrollment
3,761
Medical University of Vienna
Vienna, Vienna, Austria
Survival
overall Survival
Time frame: up to 12 years
reoperation-free survival
reoperation-free survival after either biological or mechanical AVR
Time frame: up to 12 years
reoperation
reoperation after either biological or mechanical AVR
Time frame: up to 12 years
MACEs
MACEs after either biological or mechanical AVR
Time frame: up to 12 years
heart failure
heart failure after either biological or mechanical AVR
Time frame: up to 12 years
embolic stroke or ICH
embolic stroke or ICH after either biological or mechanical AVR
Time frame: up to 12 years
myocardial infarction
myocardial infarction after either biological or mechanical AVR
Time frame: up to 12 years
non-embolic bleeding
non-embolic bleeding after either biological or mechanical AVR
Time frame: up to 12 years
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